Individual
BLAIR TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
941 W I 35 FRONTAGE RD STE 164, EDMOND, OK 73034-7375
(405) 285-2994
Mailing address
941 W I 35 FRONTAGE RD STE 164, EDMOND, OK 73034-7375
(405) 285-2994
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2922
OK
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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